Intravenous fosfomycin for the treatment of nosocomial infections caused by carbapenem-resistant Klebsiella pneumoniae in critically ill patients: a prospective evaluation
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Abstract
Intensive care unit (ICU)-acquired infections as a result of multidrug-resistant Gram-negative
pathogens remain a serious problem in critically ill patients. Adult ICU patients
who received intravenous fosfomycin were prospectively examined to assess its safety
and effectiveness as an adjunct to the antimicrobial therapy of life-threatening infections
caused by carbapenem-resistant Klebsiella pneumoniae. Fosfomycin was administered
intravenously in 11 patients for treatment of hospital-acquired infections caused
by carbapenem-resistant K. pneumoniae. Fosfomycin (2-4 g every 6 h) was administered
in combination with other antibiotics. The mean +/- SD duration of treatment was 14
+/- 5.6 days. All patients had good bacteriological and clinical outcome of infection.
All-cause hospital mortality was two out of 11 (18.2%) patients. No patient experienced
adverse events related to the administration of fosfomycin. Intravenous fosfomycin
may be a beneficial and safe adjunctive treatment in the management of life-threatening
ICU-acquired infections caused by carbapenem-resistant K. pneumoniae.